1979, 10-10 Permit: 79-5623 Plumbing FixturesPLAN NUMBER
APPLICATION/ PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
DESCRIBE WORK
FEES COLLECTED
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
ELECTRIC
WATER
LEGAL DESCRIPTION - SEE ATTACHED
of
9, Utilities
7 --
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
L
BL CK
SUBDIVISION
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
PARCEL NUMBER/S
2.
3,2 p
performance of construction.
Plumbing
DATE 101101 7 SIGNATURE i
Mech.
'o,
OWNW
SPECIAL APPROVALS
SPECIAL CONDITIONS:
PHONE
DEPT. REQ'D. RECD.
3
Plan Check
Env. Health
Q�v
SEPA
Planning
J"i�
AD ESS
41
W�`
ZIP
Required Set Backs in Feet
Fire Marshall
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North South
East West
CO RACTOR
C.� l'�
PHONE
Size of Parcel
Zone Classification
4.—ADDRESS
t �1��
TOTA L $
ZIP
Type Const.
Occupancy
Sprinklered
WHEN MACHINE VALIDAT
SEPA Checklist
THIS BECOMES A PERMIT.
i Ir- _
�-
DATE OFFICIAL
❑Yes ❑No ❑ Req'd.
APPROVED FOR ISSUANCE
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
ADDRESS
ZIP
DWL Area
Basement Area
Garage Area
Storage
CHANGE OF USE FROM
TO
Split Entry
Split Level
Rancher
6.
No. Baths
No. Floors
No. Rooms
Rec. Room
TYPE ❑ NEW
❑ ALT. ❑ AD'N. ❑ RPL.
❑ MVE.
7,
OF❑
OF
OTHER
El BLD.
ElPLMB. E)MECH: ❑ M.H.
-1
CERTIFICATE
Req'd.
Recd.
Nat Req'd.
WORK
of EXEMPTION
DESCRIBE WORK
FEES COLLECTED
8 —3
VALUATION Cl Source GAS
ELECTRIC
WATER
SEWER
of
9, Utilities
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
3,2 p
performance of construction.
Plumbing
DATE 101101 7 SIGNATURE i
Mech.
'o,
SPECIAL APPROVALS
SPECIAL CONDITIONS:
DEPT. REQ'D. RECD.
/
3
Plan Check
Env. Health
Q�v
SEPA
Planning
J"i�
W�`
Mobile Home
Fire Marshall
�co ���"""�t'/
'3 o
Co. Engineer
Other (Spefif )
Utilities
1
t �1��
TOTA L $
Zone Clearance
AC,
WHEN MACHINE VALIDAT
SEPA Checklist
THIS BECOMES A PERMIT.
i Ir- _
�-
DATE OFFICIAL
1� (i
APPROVED FOR ISSUANCE
PERMIT NUMBER
DATE
03* *35.50
*35.50
*35,50
E *0.00 00
56222
10-10-79
;F 6479,
IN THIS SPACE,